Long-Term Follow-Up of Paddle Lead Cervical Spinal Cord Stimulation for Failed Neck Surgery Syndrome

Keywords: pain, electrical stimulation, cervical spine, complications, spinal cord

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     Failed neck surgery syndrome (FNSS) describes patients with intractable chronic neck and/or upper extremity pain despite surgery for cervical degenerative disease.
     Six of 8 patients (75%) underwent permanent paddle lead and pulse generator implantation.
     We identified 8 patients with FNSS that underwent a trial of paddle cervical SCS for FNSS by a single neurosurgeon. Follow-up was obtained via telephone interviews and the mean follow-up was 6.2 years.
     The mean reduction in pain for patients undergoing implantation was 55.2% (50-70%). All 6 patients were initially satisfied with cervical SCS and reported a mean duration of satisfactory pain relief of 2.0 years (0.5-3.0 years). Moreover, during this period of pain relief, all 6 patients claimed that cervical SCS improved their quality of life and 5 patients (83.3%) reported that their pain medication requirements decreased due to successful cervical SCS. However, at a mean follow-up of 6.2 years, only 1 patient continues to use the SCS for pain control. Four patients described a loss of efficacy after initial satisfactory pain relief and 1 patient had the SCS system explanted in the setting of fevers of unknown origin. Four of 6 patients (66.7%) said they would undergo cervical SCS again.
     This is a retrospective study.
     Paddle lead cervical SCS appears to be able to provide certain patients with FNSS improved quality of life and significant pain relief.
     We feel that cervical SCS has a role in FNSS patients however technological advances are needed to improve the disappointing long-term pain relief in this patient population.


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